PROJECT SUMMARY The WHO estimates that NCDs are the 2nd leading cause of death in sub-Saharan Africa (SSA), accounting for 30% of the 9.5 million deaths in Africa. The number of people with hypertension in SSA will increase by 68% from 75 million in 2008 to 126 million in 2025. In Ghana and Nigeria, the burden of stroke and CVD has grown in the past decade; and it is estimated that the scant resources in SSA countries would be depleted by the disability from CVD if this epidemic go unabated. Thus, strengthening research capacity in prevention of stroke and CVD is an urgent priority. However, research productivity and collaboration among African scientists is abysmally low. In order to address this problem, we developed a Cardiovascular Research Training (CaRT) program (D43TW009140; MPI: Ogedegbe, Adanu & Tayo) that trained 64 investigators between 2012-2017 in Ghana and Nigeria. Led by 4 accomplished African scholars (Ogedegbe, Adanu, Ovbiagele & Tayo), this renewal application, will broaden the scope of CaRT to include stroke prevention. The proposed program, known as Stroke-CaRT, is a consortium of NYU, UCSF, Loyola University and two African countries (Ghana and Nigeria). We will enroll 100 trainees in 4 cohorts of 25 trainees (12-13 from each country) in either a Health Services Research (HSR) track or a Patient-Oriented Research (POR) track. Trainees in the HSR track will be chosen from candidates with a background in public health (nurses, pharmacists, etc.), while those in the POR track will be chosen from a pool of physicians enrolled in postgraduate residency programs. The unifying theme of both tracks is trainees? common interest in stroke and CVD. The 2-year program comprises: (a) three 2-week Intensive Research Courses in Year 1; and (b) a Mentored Research Experience in Year 2, during which trainees will conduct Mentored Research Projects and attend monthly Advance Seminars via WebEx to discuss their progress. We will utilize a multidisciplinary ?twinning? strategy whereby trainees with similar expertise will be paired to work in teams of 4 [two from each country] in order to foster between-country collaborations. The program is built on an infrastructure of NIH grants between the PIs and their colleagues in Ghana and Nigeria: Bioethics training grant (R25TW010886; Art & Ogedegbe); implementation research in HTN (U01HL138638; Ogedegbe) and stroke (R21 NS103752; Ovbiagele), stroke epidemiology (R01NS107900; R21TW010479 & U54HG007479; Ovbiagele); stroke genomics (R01NS107900; Ovbiagele) and primary stroke prevention in sickle cell disease (R01NS094041; Debaun M). The training will occur yearly in Ghana and Nigeria, rather than the United States, in order to mitigate the risk of ?brain drain? that is often inherent in sending African scholars abroad for training. Upon completion, trainees will acquire skills needed to conduct scientifically rigorous research in stroke prevention and CVD risk reduction in Africa. Our long-term goal is to develop a sustainable network of trainees with expertise in HSR and POR, who are poised to assume leadership roles in academia in SSA.